The Brave New World of Healthcare: What Does the ASC Landscape Look Like?

At the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago on June 13, Goran Dragolovic, senior vice president of operations at Surgical Care Affiliates, shared his observations on the macro-level trends changing healthcare and the ambulatory surgery center industry.

The majority of changes in the market are motivated by a need to curb overall spending. "We have been in a bubble of healthcare spending that is absolutely unsustainable," said Mr. Dragolovic. The high variability in cost and utilization in healthcare is increasingly coming to light. Those that can impact and lower high cost areas will be key, and sustainably successful, players in the healthcare field.

The Patient Protection and Affordable Care Act is the root of the majority of changes transforming healthcare. "The ACA is sweeping in its breadth and intent," said Mr. Dragolovic. "Not a single part of healthcare remains unaffected." In the wake of the PPACA, new models of care and payment are on the rise. Accountable care organizations have begun to bring together health systems, physicians and payers. The discussion surrounding patient care has shifted to focus on population health management and how all stakeholders can play a role. "The lines demarcating us [in healthcare] are now blurring," said Mr. Dragolovic.

Change breeds uncertainty, and as a result there has been a significant uptick in consolidation. "We are seeing two emerging markets: some physician groups have merged to compete in this brave new world or hospitals are merging to do the same," he said. "The more dominant of a presence you have, the more you control costs." Thus far, physician-driven markets have demonstrated overall lower expenditure, while hospital-driven markets demonstrate higher costs.

Considering these major trends, where do ASCs stand? "Surgery represents 30 percent of total healthcare spending," says Mr. Dragolovic. "Everyone looking at the big picture will start with working to improve the biggest areas of cost." The ASC industry is at the center of an area that is a big concern for all key stakeholders. This level of attention is both intimidating and an immense opportunity for ASCs to demonstrate at a national level what industry members have known for years: high quality outcomes and low costs.

With this opportunity, ASC leaders must ask themselves: "Are we transforming surgical delivery or being swept away by the tide?" To become a part of the solution in the new world of healthcare, the ASC industry will actively gain understanding the delivery of care network, participate in clinical care coordination and design innovative payment models.